Study protocol 75 internal consistency; convergent and divergent validity are generally acceptable (43). The authors differentiate three subscales: ‘self-empowerment’ (13 items), ‘learning and new potentials’ (15 items) and ‘spirituality’ (2 items). The Internal Stigma of Mental Illness (ISMI (44)); 29 items. This scale is designed to measure the subjective experience of stigma, with subscales measuring Alienation, Stereotype Endorsement, Perceived Discrimination, Social Withdrawal and Stigma Resistance. The ISMI has high internal consistency and test-retest reliability. Construct validity and divergent validity were supported by comparisons with scales measuring related constructs. One item of the Quality-of-Life section of the Cumulative Needs for Care Monitor (CNCM (45)), which asks: ‘’Can you tell me how satisfied you are with your life as a whole?” This item correlates strongly with the total score of this Quality-of-Life section. The Self-Esteem Rating Scale-Short Form (SERS-SF (46)), 20 items. This scale has two subscales: positive and negative self-esteem. It also has good internal consistency, good test-retest reliability and adequate convergent validity for people with schizophrenia. In line with Mueser’s conceptual framework, we consider improving on personal goals to be a mediator variable between illness self-management and recovery ((2), p. S35). We will measure this with Granholm’s Goals Template (47), an instrument for Goal Attainment Scaling that measures progress towards goals in ten life domains: employment, housing, relationships, school, self-care; leisure activities, addictions, money-management, independence using transportation, and general template. We have developed a very short manual for this scale, whose psychometric properties have not yet been investigated. Objective recovery Objective recovery will be assessed using the Social Functioning Scale (48). Mueser defines social and role functioning as aspects of objective recovery. Both are covered with this scale, which has 19 items and the following seven dimensions: social withdrawal, relationships, social activities, recreational activities, independence (competence), independence (performance), and employment. This scale has been described as reliable, valid, sensitive and responsive to change.
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